Parliamentarians Key to Institutionalisation of Value for Money, Accountability and Sustainability in Health Sector

African Finance and Health Ministers as well as parliamentarians, civil society, bilateral and multilateral partners gathered in Tunis, and agreed to intensify multisectoral dialogue and collaboration amongst themselves, Parliamentarians, and technical and financial partners, to improve health policies and programmes that promote better value, accountability and sustainability of health investments in the continent. Participants recognized that parliamentarians have a key role to play in ensuring that Africa attains universal health coverage, the Health Millennium Development Goals (MDGs) and other developmental goals by 2015 and beyond. In addition they recognised that improved "health is instrumental to economic growth and social development" and especially "reduction of inequality, and poverty".

The conference a high level dialogue between Ministers of Finance and Health was organized by the African Development Bank and other Harmonization for Health in Africa (HHA) partners. It gathered Ministers of Finance and Health and/or their representatives from 54 African countries, African parliamentarians as well as over 400 participants from the public and private sectors, academia, civil society and media globally. His Excellency Hamadi Jebali, Prime Minister of Tunisia, Dr. Donald Kaberuka, President of the African Development Bank, and Dr. Margaret Chan, Executive Director of the World Health Organisation delivered the opening remarks.

High-profile speakers like Julio Frenk, Dean of the School of Public Health, Harvard University and Hans Rosling, Chairman of Gapminder Foundation also delivered keynote speeches during the conference.

This conference emphasized the urgent need for greater domestic accountability, reduced dependence on foreign aid and value for money in the delivery of health services in Africa. It gathered the expertise from all over Africa as well as globally featuring speakers from India, China, Brazil, Vietnam and Kyrgyzstan.

Recalling and building on the 2001 Abuja Declaration, and other regional efforts to improve domestic health financing, and underlining the involvement of Parliamentarians in the meeting, the Ministers called on parliamentarians to support the implementation of the Tunis Declaration:

"Effective integration of social, demographic and health factors into broader development strategies and policies; Effective investment in the health sector based on evidence led strategies and high impact interventions; Equitable investment in the health sector ensuring health financing is pro-poor; Improved efficiency in health systems; Sustainable health financing systems that build on and coordinate a diversity of sources; Strengthen accountability mechanisms; and increased domestic resources for health through improved revenue collection and allocation including giving priority to immunisations, non-communicable diseases, AIDS, Tuberculosis and Malaria, as well as reproductive, maternal newborn and child health."

Parliamentarians present responded to the call promising to integrate principles of the Tunis Declaration into ongoing efforts by parliamentarians to ensure improved and more efficient health investment through the Pan African Parliament, Regional and National Parliaments.

These efforts include:

The 2011 commitment and resolution of the Pan African Parliament - the parliamentary arm of the Africa Union - with the Conference of African Speakers of Parliament to prioritize policy and budget action for health especially, Maternal Newborn and Child Health, and Youth Development;

The 2010 Parliamentary Policy and Budget Action Plan on Maternal, Newborn and Child Health and Development in Africa, incorporating the Eradication of Mother to Child Transmission of HIV and AIDS, as adopted by the Chairs of African National and Regional Economic Committees (RECs) Parliamentary Committees on Finance and Budget, meeting with the Pan African Parliament (PAP) Committees on Monetary and Financial Affairs; Health, Labour and Social Affairs; and Gender, Family, Youth and People with Disabilities - for parliamentary implementation of the 2010 Africa Union Summit on Maternal Newborn and Child Health; and

The 2009 Africa Regional Parliamentary Action Plan for Health.

These initiatives in partnership with the Africa Public Health Parliamentary Network geared towards implementing and improving the AU Abuja 15% health financing commitments and various regional and global health policies and frameworks are based on the mandate and role of the parliaments to, represent demographic constituencies, ensure legislative environment and support for implementation of progressive health policies; and the oversight role of the parliaments in holding ministries and agencies of government accountable for implementing these health programmes and interventions.

Since 2008, the Africa Public Health Parliamentary Network, a network of African parliamentarians, including Chairs of Finance / Budget, and Health Committees dedicated to promoting improved health investments and health outcomes in Africa, has worked with the Pan African Parliament, Regional and National Parliaments, the African Union Commission, Economic Commission for Africa, and a range of agencies and development partners including UNFPA, UNAIDS and WHO to promote policy and budget actions to actualise improved health outcomes for Africa.

This July 2012 landmark joint ministerial conference, the Tunis Declaration, the growing work of the Parliamentary Network on health, human and social development and importantly overall parliamentary support for the Tunis declaration is a significant step for actualizing and institutionalizing Value for Money, Accountability and Sustainability in the Health Sector.

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